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Naspro et al. Mini-invasive Surg 2021;5:50 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.77

Case Report Open Access

Retroperitoneoscopic single-site 3D adrenalectomy

for left adrenal renal cell carcinoma metastasis 20
years after left laparotomic radical nephrectomy

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Richard Naspro , Giovanni La Croce , Federico Pellucchi , Marco Roscigno , Alessandro Rossini , Sara
1
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Cassibba , Lori Lerner , Luigi Filippo Da Pozzo 1,3
1
Department of Urology, Papa Giovanni XXIII Hospital, Bergamo 24127, Italy.
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Section of Urology, VA Boston Healthcare System, Boston, MA 02130, USA.
3
University of Milano-Bicocca, Milano 20126, Italy.
Correspondence to: Dr. Richard Naspro, Department of Urology, Papa Giovanni XXIII Hospital, Piazza Oms 1, Bergamo 24125,
Italy. E-mail: nasprorichard@gmail.com
How to cite this article: Naspro R, La Croce G, Pellucchi F, Roscigno M, Rossini A, Cassibba S, Lerner L, Da Pozzo LF.
Retroperitoneoscopic single-site 3D adrenalectomy for left adrenal renal cell carcinoma metastasis 20 years after left
laparotomic radical nephrectomy. Mini-invasive Surg 2021;5:50. https://dx.doi.org/10.20517/2574-1225.2021.77
Received: 18 Jun 2021 First Decision: 14 Jul 2021 Revised: 18 Jul 2021 Accepted: 2 Aug 2021 Published: 25 Oct 2021
Academic Editors: Luigi Schips, Michele Marchioni Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
The aim of the paper is to demonstrate the practicability of retroperitoneoscopic single-site 3D left adrenalectomy
after previous homolateral laparotomic renal surgery. We present a case report of a 70-year-old male who
underwent radical nephrectomy in 1999. Twenty years after radical nephrectomy, the patient underwent a
computed tomography scan for B-cell lymphoma follow-up, which revealed a 30 mm left adrenal mass suspicious
for a delayed renal-cell carcinoma metastasis. After multidisciplinary discussion, surgery was chosen as first
option. To minimize surgical morbidity as much as possible, a 3D laparoscopic single-site retroperitoneal approach
was chosen. The patient had no peri- or intra-operative complications and was discharged on Postoperative Day 3.
The final histological report revealed an adrenal clear cell renal-cell carcinoma metastasis. This experience shows
that single-site retroperitoneal laparoscopic adrenalectomy is possible in patients who underwent previous
abdominal cancer surgery and is an option to consider when determining optimal approaches for adrenal surgery.

Keywords: Adrenalectomy, laparoscopy, laparoendoscopic single-site surgery, renal cell carcinoma metastases

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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